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Nine months ago, John Schmidt had prehypertension. His body mass index was on the high side, and even though his wife was urging him to eat more healthfully and exercise more, the habit never quite stuck.

The boost he needed came not from his wife or doctor, but his workplace and co-workers at Tri-State Wholesale Flooring in Sioux Falls.

The company implemented a workplace wellness program last year. He’s spent the past nine months talking with a health coach about personal goals, doing health challenges such as using a pedometer to track how many miles he walks in a day, and learning how to eat and live more healthfully.

Schmidt, 46, has learned that on a good day he walks 4.5 miles. He’s lost 27 pounds, brought his blood pressure back down to normal and is making better decisions with food.

“The biggest thing with this is just awareness and then being involved with a group atmosphere or attitude,” he said. “It’s not like anybody’s sitting around here giving each other a hard time because of what we’re eating. You’re involved with a group of people that are collectively trying to be healthier.”

Experts will say Schmidt is a hallmark example of a successful wellness program, and that stories such as his are a key motivating tool for co-workers.

It’s estimated that $2.6 trillion is spent in the U.S. on health care costs annually, and companies are increasingly looking for ways to stop the loss — 44 percent of midsized companies and 79 percent of large companies now offer a wellness program, according to an ADP Research Institute study. A majority, 64 percent of midsize businesses and 71 percent of large companies, say one of the reasons they offer the program is to control health care costs. Another common reason is improving employee health.

Cost savings, retention for businesses

But it’s not just about health care costs, nor should it be, experts say. Successful programs can boost morale, increase productivity, reduce absenteeism and also be a tool for retention. In short, it’s just good business.

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“You kind of need to change the culture,” said Kandy Jamison, who leads WellConneXions, a workplace wellness division of Howalt-McDowell Insurance. “You want the message to be that ‘I care about my employees and that’s why I’m implementing the program,’ and hopefully (there will be) a cyclical effect with the health costs.”

And while not every employee will participate, getting the ones who do to do it wholeheartedly can make a difference. Studies indicate that companies can reduce health care claims by reducing the risk factors in employees.

A recent study by The Vitality Group, a third-party provider of wellness programs, found that companies can find an optimum of 18 percent savings per employee by decreasing costs for ailments wellness programs typically try to cover, such as high blood pressure, obesity or cardiovascular disease. That’s a best-case scenario if a company is able to reduce everyone’s risk factors to zero, said Jonathan Dugas, director of clinical development for The Vitality Group.

A 2010 Harvard analysis of cost savings found that companies with 300 employees or more saw a $3.27 drop in medical costs for every $1 spent on a wellness program. Also, absenteeism costs fell $2.73 for every $1 spent.

One success story is the state of Nebraska, which implemented a wellness program three years ago and last year won the C. Everett Koop National Health Award. The program offers a variety of preventive coverage and wellness options including free tobacco cessation medications, reduced co-pays for diabetic and high blood pressure medications and no age restrictions for preventive screenings. Other parts of the wellness program include health coaching, free pedometers, online cardio logs and onsite biometric screenings.

The state has reduced its medical and pharmacy claims spending by $4.2 million when comparing wellness program participants versus nonparticipants. The return on investment has been $2.70 in health care savings for every $1 spent, based on a study done on the program by the Wellness Council of America. From 2010 to 2011, the average number of risk factors per person decreased from 1.72 percent to 1.55 percent.

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Alcon, a Texas company that manufactures eye care surgical equipment, was the 2011 C. Everett Koop National Health Award winner and saved$1.5 million in medical and pharmacy claims in 2010 alone. The company also has experienced improved employee wellness, according to The Vitality Group website, which provides the company’s wellness program. More than half the employees who were labeled as high risk in 2008 for high cholesterol and blood pressure moved to the moderate or low-risk designation by 2010.

Engaging employees can lift morale in workplace

Jamison said wellness programs also provide intangible results, namely, boosting productivity and morale in the workplace.

“People have a different mindset about work,” she said.

Evaluation of success has evolved. At first, the focus was on participation. Now, it’s on people such as Schmidt buying into the program. Are they really making life changes or just going through the motions to get the premium reduction?

“What we’ve learned is participation isn’t the key, engagement is the key,” Jamison said. “A company might only have 30 people engaged, (but) walking the walk, they’re going to move the needle for you.”

More often than not, companies have some sort of program in place, and Jamison expects that growth to continue, particularly as the Affordable Health Care Act is implemented.

Business incentives in Sioux Falls, state

Even the city of Sioux Falls and state are getting involved with communitywide programs. The city is pushing healthful lifestyles through its Live Well Sioux Falls initiative. The state Health Department has a Healthy South Dakota initiative, which offers grants to companies annually to help with the costs of workplace wellness programs and last year held its first Work Well Summit in Sioux Falls for which 200 people registered. They’ll hold two more this year, said Linda Ahrendt, chronic disease director.

“We’re just trying to find as many venues as we can to get the message out about making healthy choices hopefully the easier choices,” Ahrendt said.

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Programs can be simple, offering employees free annual screenings to check important health indicators like blood glucose levels, blood pressure and cholesterol; smoking cessation programs or monthly lunch-and-learn seminars to help educate employees on ways to eat and live healthier. Topics often go beyond weight loss and nutrition and include dental hygiene, stress management and other wellness issues. Other companies do monthly health challenges, have on-site gyms or offer membership rebates, and provide employees with one-on-one health coaching.

Many companies now offer reductions on health care premiums for those who participate. Some wellness programs offer participants other incentives.

Different measures of gauging success

The results can vary and be difficult to quantify.

“How many high blood pressures did you stop from happening because you implemented a gym membership?” Jamison said. “You don’t know that.”

But studies also indicate overall that there is a cost benefit, Jamison said. The challenge for some companies is that it can take 3 to 5 years to see a return on investment.

“We know it’s the right thing to do, and we know we want to take care of our employees,” Jamison said. “But when we start to see the expenses that come with the wellness program, that tends to put brakes on the program a little bit. ... But the statistics and studies and white papers are all out there that definitely say it does provide a positive return on investment.”

At Tri-State Flooring, it’s too early to tell what savings the program is providing. But to some extent employees already are recognizing benefits.

“Obviously, from an ownership standpoint you need to pursue those things that can lead to retention,” said John Rozell, president of the company that employs about 25 people in Sioux Falls. “Better health is individual responsibility, but I think it’s a corporate responsibility to make things available. It doesn’t take a rocket scientist to figure out if you have healthier people, in the long run you’re going to have a better chance of curbing health care costs.”

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The company’s premiums have been increasing on average 10 percent the past two years, Rozell said. They were scheduled for a 15 percent increase in 2012, but their health care provider knocked the increase down due to the implementation of a wellness program, he said.

The company is working with WellConneXions and offers health and wellness challenges for employees that include everything from walking and drinking water to dental hygiene health. Employees also have health coaches, can do screenings and recently started receiving a gym membership reimbursement.

This summer during a walking challenge, five teams logged 2,000 miles, Rozell said.

But the larger effect is evident just by looking around the building, he said.

Schmidt agrees.

“Overall, what I can say is that visibly, the 20-something people that work here are healthier looking,” he said. “Everyone likes to focus on weight loss. It’s not just the weigh loss. It’s overall wellness. ... During stressful situations, people tend to get through them better.”

Health coaches, gyms for employees

Showplace Wood Products in Harrisburg has been growing its wellness program. It has an on-site gym and this year added health coaching to the menu as part of a new 5-Star program that’s linked to premium incentives, said Renee Storm, human resources director.

“We took a bold step this year, and we not only are requiring people who are on our health plan to take a health risk assessment but also do the biometric screens,” Storm said. Other things include meeting with the health coach, being a nonsmoker and getting an annual exam.

“If they do all these things, they get a discount on premiums,” she said.

The introduction of the five-step program also allowed them to maintain premiums last year instead of seeing an increase through their provider, Storm said.

“We want our people to be healthy for their sake, not just for ours,” Storm said. “Healthy employees are happier and more productive, and we care about them and their health. ... that’s going to help with our premium rates also.”

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One employee, Julie Portice, 51, has been a direct benefactor of the company’s approach, though at first she wasn’t interested in the program.

“I was just the type of person, I’m here to work, just leave me alone,” she said.

But two years ago, at the behest of co-workers, she went in for a biometric screen. She found that she had thyroid issues and high cholesterol, two things she never would have realized without the tests.

“I went up there, and they couldn’t even register my cholesterol on their machine,” she said.

That led to a visit with her doctor. Now she’s on medication, and with the help of a nutritionist and trainer is eating more healthfully and exercising more. Her son also works with a nutritionist through Showplace.

“I didn’t have a lot of energy ... just walking was tough,” Portice recalled. “It was hard to get through the day just because my thyroid was really out of whack. Now, I feel great. I have a lot of energy.”

Successful programs involve everyone

So what does make for a successful program?

Experts say it doesn’t necessarily mean an expensive program. In fact, Jamison said it can be best to implement things slowly so it’s not overwhelming and also to let employees help lead the way in what they’re interested in.

Dugas said all parties need to be engaged: employers, employees and the wellness-program provider. That means involvement from the top down and providing examples of success stories that other employees can relate to, Dugas and Jamison said.

“If your leadership endorses or commits to something, then you’re going to see the people being led,” Dugas said. “They’re also going to see that example and they’re going to follow that, and wellness is no different.”

Many companies focus on health assessments, which are important as a starting point, but successful programs go beyond that by providing a variety of opportunities to get people active, decrease stress, eat healthier or reach whatever goal individual employees want to meet.

To reach a level of engagement, many companies provide incentives. Commonly, that comes in the form of decreased premium rates.

The Vitality Group, for instance, has a virtual mall. People earn points for, say, an annual screening or reaching an exercise goal, and then can make an actual purchase such as an electronic book, similar to earning airline miles on a credit card.

“I think most people wouldn’t disagree about, yes, I need to be healthy, I need to lower my blood pressure,” Dugas said. “When you’re kind of younger and you’re not really experiencing any signs of elevated health risk, it’s tough to get moving ... we kind of feel like, if you give people the extra reason to do it, that will get them going in the right direction.”